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2018 Endovascular Reimbursement Coding Fact Sheet

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2018 Endovascular Reimbursement Coding Fact Sheet 2018 Endovascular Reimbursement Coding Fact Sheet The information contained in this document is provided for informational purposes only and represents no statement, promise, or guarantee by Cordis Corporation concerning levels of reimbursement, payment, or charge. Similarly, all CPT, ICD-10 and HCPCS codes are supplied for informational purposes only and represent no statement, promise, or guarantee by Cordis that these codes will be appropriate to specific circumstances or products or services provided or that reimbursement will be made. Providers are ultimately responsible for exercising their independent clinical judgment to determine medical necessity for individual patients and the appropriate billing process according to the applicable payer’s current policy. CPT codes and descriptions are copyright 2018 American Medical Association. ICD-10 codes and descriptions are copyright 2018 World Health Organization; revised for use in the United States by the Centers for Medicare and Medicaid Services (CMS) and the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics (NCHS) as ICD-10-CM / ICD-10-PCS. Healthcare Common Procedure Coding System (HCPCS) Level II codes and descriptions are maintained by the CMS HCPCS Workgroup. The information contained in this document is taken from various publicly available documents, is current at the date of publication and is subject to change at any time. CPT® Codes and Physician Reimbursement Medicare Part B pays for physician services based upon the Medicare Physician Fee Schedule (MPFS). Fee schedule amounts are calculated according to the Resource-Based Relative Value Scale (RBRVS), which is updated each year. Procedures are reported using CPT® codes.1 The 2018 CPT Professional Edition Manual also provides specific instructions for reporting particular families of codes. Individual payers may also have guidelines and coverage policies regarding certain services. The following table lists the most commonly used codes for biliary diagnostic and therapeutic procedures. Procedure Codes and Physician Reimbursement for Endovascular Procedures 2018 Medicare Base CPT® 2018 Work 2 Description Payment Rate Code RVUs Non-Facility Facility Nonselective and Selective Catheter Placement - Arterial 36100 Introduction of needle or intracatheter, carotid or vertebral artery 3.02 $496 $162 36120 Introduction of needle or intracatheter; retrograde brachial artery 2.01 $427 $106 36140 Extremity artery 1.76 $437 $95 36200 Introduction of catheter, aorta 2.77 $572 $146 Selective catheter placement, arterial system; each first order thoracic or 36215 4.17 $1,031 $222 brachiocephalic branch, within a vascular family Initial second order thoracic or brachiocephalic branch, within a 36216 5.27 $1,118 $286 vascular family Initial third order or more selective thoracic or brachiocephalic branch, 36217 6.29 $1,899 $342 within a vascular family Additional second order, third order, and beyond, thoracic or +36218 1.01 $258 $54 brachiocephalic, within a vascular family Selective catheter placement, arterial system; each first order abdominal, 36245 4.65 $1,337 $250 pelvic, or lower extremity artery branch, within a vascular family Initial second order abdominal, pelvic, or lower extremity artery 36246 5.02 $840 $267 branch, within a vascular family Initial third order or more selective abdominal, pelvic, or lower 36247 6.04 $1,530 $317 extremity artery branch, within a vascular family 1 2018 Current Procedural Terminology (CPT®), ©2018 American Medical Association. CPT® is a registered trademark of the American Medical Association. 2 The MPFS payment amounts are based upon data elements published by the Centers for Medicare and Medicaid Services (CMS-1677-F) in the Final Rule [CMS-1654-F] on August 14, 2017, and published in the Federal Register on December 14, 2017, with a conversion factor of $35.99. CMS may make adjustments to any or all of the data inputs from time to time. 1 of 11 2018 Endovascular Reimbursement Coding Fact Sheet Procedure Codes and Physician Reimbursement for Endovascular Procedures 2018 Medicare Base CPT® 2018 Work 2 Description Payment Rate Code RVUs Non-Facility Facility Additional second order, third order, and beyond, abdominal, pelvic, or +36248 1.01 $156 $51 lower extremity artery branch, within a vascular family Diagnostic Imaging - Arterial 75600 Aortography, thoracic, without serialography, radiological S&I 0.49 $204 $25 75605 Aortography, thoracic, by serialography, radiological S&I 1.14 $140 $57 75625 Aortography, abdominal, by serialography, radiological S&I 1.14 $139 $57 Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, 75630 1.79 $174 $90 by serialography, radiological S&I Computed tomographic angiography, abdominal aorta and bilateral 75635 2.40 $449 $121 iliofemoral lower extremity runoff, with contrast material(s) 75658 Angiography, brachial, retrograde, radiological S&I 1.31 $171 $66 75705 Angiography, spinal, selective, radiological S&I 2.18 $258 $118 75710 Angiography, extremity, unilateral, radiological S&I 1.75 $175 $88 75716 Angiography, extremity, bilateral, radiological S&I 1.97 $199 $99 Angiography, visceral, selective or supraselective (with or without flush 75726 1.14 $152 $57 aortogram), radiological S&I 75731 Angiography, adrenal, unilateral, selective, radiological S&I 1.14 $175 $59 75733 Angiography, adrenal, bilateral, selective, radiological S&I 1.31 $188 $65 75736 Angiography, pelvic, selective or supraselective, radiological S&I 1.14 $163 $56 75741 Angiography, pulmonary, unilateral, selective, radiological S&I 1.31 $153 $64 75743 Angiography, pulmonary, bilateral, selective, radiological S&I 1.66 $172 $82 Angiography, pulmonary, by nonselective catheter or venous injection, 75746 1.14 $154 $57 radiological S&I 75756 Angiography, internal mammary, radiological S&I 1.14 $176 $58 Angiography, selective, each additional vessel studied after basic +75774 0.36 $88 $18 examination, radiological S&I Nonselective and Selective Catheter Placement - Venous 36005 Injection procedure for extremity venography 0.95 $332 $50 36010 Introduction of catheter, superior or inferior vena cava 2.18 $492 $114 36011 Selective catheter placement, venous system; first order branch 3.14 $847 $164 36012 Second order, or more selective, branch 3.51 $868 $181 Diagnostic Imaging - Venous 75820 Venography, extremity, unilateral, radiological S&I 0.70 $118 $36 75822 Venography, extremity, bilateral, radiological S&I 1.06 $138 $53 75825 Venography, caval, inferior, with serialography, radiological S&I 1.14 $137 $57 75827 Venography, caval, superior, with serialography, radiological S&I 1.14 $141 $58 2 of 11 2018 Endovascular Reimbursement Coding Fact Sheet Procedure Codes and Physician Reimbursement for Endovascular Procedures 2018 Medicare Base CPT® 2018 Work 2 Description Payment Rate Code RVUs Non-Facility Facility 75831 Venography, renal, unilateral, selective, radiological S&I 1.14 $143 $57 75833 Venography, renal, bilateral, selective, radiological S&I 1.49 $169 $75 75840 Venography, adrenal, unilateral, selective, radiological S&I 1.14 $151 $59 75842 Venography, adrenal, bilateral, selective, radiological S&I 1.49 $181 $77 Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, 75860 1.14 $147 $57 catheter, radiological S&I 75870 Venography, superior sagittal sinus, radiological S&I 1.14 $151 $59 75872 Venography, epidural, radiological S&I 1.14 $151 $59 75880 Venography, orbital, radiological S&I 0.70 $128 $36 Renal Artery Angiography Selective catheter placement and radiological S&I, main renal artery and 36251 5.10 $1,412 $273 any accessory renal artery(s) and renal angiography S&I; unilateral 36252 Bilateral 6.74 $1,527 $378 Superselective catheter placement (one or more second order or higher 36253 renal artery branches) renal artery and any accessory renal artery(s) and 7.30 $2,255 $375 renal angiography S&I; unilateral 36254 Bilateral 7.90 $2,205 $442 Cerebrovascular Angiography Non-selective catheter placement, thoracic aorta, with angiography of 36221 the extracranial carotid, vertebral, and/or intracranial vessels, unilateral or 3.92 $1,048 $210 bilateral, and all associated radiological S&I, includes arch, when performed Selective catheter placement, common carotid or innominate artery, 36222 unilateral, any approach, with angiography of the ipsilateral extracranial 5.28 $1,234 $296 carotid circulation and all associated radiological S&I, includes arch Selective catheter placement, common carotid or innominate artery, unilateral, any approach, with angiography of the ipsilateral intracranial 36223 5.75 $1,546 $329 carotid circulation and all associated radiological S&I, includes angiography of the extracranial carotid and cervicocerebral arch, when performed Selective catheter placement, internal carotid artery, unilateral, with 36224 angiography of the ipsilateral intracranial carotid circulation, includes 6.25 $1,964 $373 angiography of the extracranial carotid and cervicocerebral arch Selective catheter placement, subclavian or innominate artery, unilateral, 36225 with angiography of the ipsilateral vertebral circulation and all associated 5.75 $1,488 $328 radiological S&I, includes angiography of the arch, when performed Selective catheter placement, vertebral artery, unilateral, with angiography 36226 of the ipsilateral vertebral circulation and all associated radiological S&I, 6.25 $1,904 $370 includes angiography of the arch, when performed Selective catheter placement, external carotid
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